"Mr. Zheng, I'm Lao Zhou from the Department of Orthopedics." A slightly girly voice came from the other side of the phone.
It's Dr. Zhou from the Department of Orthopedics. He's a nice guy, but he talks a little bit.
This voice was so recognizable that Zheng Ren recognized it immediately.
"Brother Zhou, what's wrong?"
"Are you busy? Lumbar vertebra resection, interventional surgery on the patient..." The voice on the other side of the phone was hesitant, "Can the surgery be done right away?"
Um? Why are you so anxious
"I have nothing to do now. Is the patient fasting and drinking enough time?" Zheng Ren said indifferently.
"Enough! Enough!" Dr. Zhou said quickly, "This operation is performed by a professor from the Imperial Capital. The professor has something to do at the moment. He will either fly out early tomorrow morning to do it, or he will have to wait three to five days."
Dr. Zhou quickly explained that after all, it was almost time to get off work, and asking Zheng Ren for surgery was based on personal feelings.
"The patient is in severe pain and needs a lot of pain relief every day. I'm wondering if the sooner I do it, the less suffering the patient will suffer."
"It's okay, Brother Zhou. There is no emergency surgery here. If it's convenient for you, just ask the family to sign and you can just send the patient directly." Zheng Ren said with a smile.
"Okay, okay." Dr. Zhou agreed hastily, "I'll ask the family to find you right away."
After that, the phone was hung up.
Zheng Ren immediately started writing the pre-operative instructions. Since it was the first time for a new surgery, Zheng Ren thought about the possible complications and wrote them down.
When the professor saw Zheng Ren starting to work, he came over and asked, "Mr. Zheng, are you going to have surgery right away?"
"Yeah." Zheng Ren replied.
"Your work here is really day and night." Seeing that he was about to get off work and have an operation, as a stereotypical German, the professor must have some ideas.
Off-duty time is private, and the professor is really not used to this kind of pace of life that does not distinguish between public and private matters.
This is no life, it is like being sold to the hospital as a slave.
But the professor was still reluctant to leave. Even if he wanted to leave, Zheng Ren would not stop him.
The 64-slice CT three-dimensional reconstruction at noon opened a door for the professor to vaguely see a new world.
As for the scenery of this world, we may be able to get a clue from this operation.
The professor only hesitated for a second before making up his mind to stay.
Zheng Ren had no idea about the professor's rich inner drama. He proofread the pre-operative instructions one by one. When the young woman arrived, Zheng Ren was still thinking hard about the various complications that might occur.
Write down everything you can think of and explain it to the patient’s family.
The young woman doesn't care. In her words, this is the time when the family is doing their best and the doctor is doing his best.
And she has also done a good job of psychological preparation. If she really can't get off the stage, she will suffer less.
She signed the preoperative instructions printed by Zheng Ren without hesitation, and then went back to send the patient to the emergency ward to prepare for the operation.
Zheng Ren called the operating room to prepare for the operation. Then he took the professor to the operating room without calling Su Yun.
Finally, when Zheng Ren had time, Professor Rudolf kept asking questions related to the three-dimensional reconstruction of 64-slice CT that he had just thought of.
Zheng Ren had no intention of answering the professor's questions. He kept his head down and changed his clothes. He only occasionally communicated with the professor.
All he was thinking about were issues related to transverse lumbar artery embolization surgery.
It is better to go to the system operating room for training. Experience in ten or twenty surgeries is enough.
Zheng Ren is now rich and powerful, and he has tried the new technique for the first time ten or twenty times.
As for how many hours each time would take, Zheng Ren didn't think much about it.
If it were done before, I would never dare to do this.
From simplicity to luxury, this is the principle.
After changing his clothes, Zheng Ren asked Professor Rudolf to prepare for the operation, while he went to the small smoking room, lit a purple cloud, and entered the system space.
After purchasing surgical training time, the system operating room was built, and the experimental subject appeared in front of Zheng Ren.
The lumbar artery, also called the transverse lumbar artery, is divided into two terminal branches, anterior and posterior, on the anterolateral side of the intervertebral foramen.
The anterior branch runs along the ventral side of the corresponding lower edge of the transverse process and the intertransverse process ligament, passes behind the transversus abdominis aponeurosis, and passes between the transversus abdominis and internal oblique muscles to supply the tissues of the posterolateral abdominal wall.
When the posterior branch begins to emerge, it sends out a thinner anterior branch of the intervertebral foramen into the spinal canal at the front edge of the intervertebral foramen, supplying the area in front of the dura mater and behind the vertebral body.
At the same location, the main trunk of the posterior branch sends out nutrient branches that enter the lumbar plexus nerve trunk outwards and downwards.
What needs embolization is not only the nutrient branches from the main trunk of the posterior branch extending outward and downward into the lumbar plexus nerve trunk, but also the abnormally proliferated feeding blood vessels of the main trunk and the abnormally proliferated blood vessels of tumor tissue.
This was already determined during the 64-slice CT three-dimensional reconstruction at noon.
Because the patient has an advanced tumor, the surgery is also a palliative surgery to improve the quality of life. Therefore, while avoiding complications, the feeding blood vessels of the vertebral body should be embolized as much as possible.
A simple destructive surgery is not that difficult. In the past, this kind of surgery did not involve interventional embolization of the transverse lumbar artery, and the intraoperative bleeding should be 3000-5000 ml.
This is a daunting number.
However, if the transverse lumbar artery is embolized, the bleeding volume can be controlled to 1500-2000 ml, reaching an acceptable level.
During surgical training, Zheng Ren performed the first operation for nearly three hours.
Because Zheng Ren didn't want to just plug out the main trunk of the posterior branch. In that case, although the operation would be relatively simple, it would still be able to reach the level required by the Imperial Orthopedics Professor.
However, the patient's intraoperative bleeding is about 1500 ml, which will still have a huge impact on dying patients.
To improve the patient's quality of life, it is important to bleed as little as possible.
Not only the transverse lumbar artery or the left and right intercostal arteries should be embolized, but nearby small blood vessels should also be embolized as much as possible to ensure that surgical bleeding is minimized.
In fact, Zheng Ren didn't need to do this at all.
However, as a doctor, when possible, we always want to help patients recover as soon as possible. For those who cannot be cured, try to improve the quality of life during the survival period.
The spinal cord has an extremely rich supply of blood vessels. Except for the adamchiviz artery, which had to be avoided as much as possible, Zheng Ren also carefully performed angiography. He found that there was no impact on other organs or the spinal cord, and it was simply supplying blood to the tumor, so he embolized it.
The operation went very slowly, and Zheng Ren gradually mastered some corresponding embolization techniques.
The level of intervention at the master level is no joke.
Even so, after training for ten surgeries, he could only complete transverse lumbar artery embolization surgery once every two hours.
To a certain extent, this kind of surgery is more difficult than prostate embolization to meet Zheng Ren's requirements.
After all, even if the proliferated capillaries of the prostate are ectopically embolized, it will not cause the patient's death.
Just like the patient treated by Professor Rudolf Wagner, the superior vesical artery was embolized. The patient only had symptoms such as urinary weakness, and an indwelling urinary catheter was sufficient.
This time, the arteries to be embolized were near the blood vessels that feed the spinal cord.
If not careful, the patient will suffer paraplegia of the lower limbs and even respiratory arrest, leading to death.
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